The questionnaire contained validated scales to assess inclusive leadership of head nurses and attending physicians, nurse-physician collaboration, collaborative decision-making, psychological safety, workload, intention to quit and a newly developed scale for perceived futile care.
The results of this study led to the creation of a collaborative network of psychological support to medical students by the Brazilian Association for Medical Education in all regions of Brazil.
Longer pre-baseline duration of the depressive episode in the WHO Collaborative Project on Psychological Problems in General Health Care study was a predictor of a poor course of depression [ 58].
Several of the study sites (Netherlands [ 55], Italy [ 36] and US [ 57, 71]) involved in the multi countries WHO Collaborative Project on Psychological Problems in General Health Care have published results independently.
The review also includes two multi-country studies: the Longitudinal Investigation of Depression Outcomes in primary care (LIDO) [ 44] and the World Health Organization (WHO) Collaborative Project on Psychological Problems in General Health Care [ 69].
The individual results are presented from these sites alongside the cumulative results from the WHO Collaborative Project on Psychological Problems in General Health Care in Table 2. Consecutive and convenience sampling methods were used in the majority of studies.
The US site of the WHO Collaborative Project on Psychological Problems in General Health Care found that participants with higher symptom severity as measured by the GHQ-28 at baseline, and more disability, were more likely to receive antidepressant medication or use any specialty mental health services [ 71].
According to (Vygotsky's 1962 , 1986 theory of verbal self- regulation, the progression from an inter-psychological plane (collaborative discourse with questions embedded in the conversation) to intra-psychological plane (individual internal dialogue with self) is the fundamental concept in his theory.
There is good evidence that collaborative care that includes psychological therapy with or without drugs is more effective than collaborative care that includes only drugs, and our trial would support this finding.
Collaborative care that integrated brief psychological interventions within the context of routine primary care management of long term conditions reduced depressive symptoms more than usual care in patients with multimorbidity.
